High Oaks Dental Practice

We carried out this announced comprehensive inspection on 11 July 2023 under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

We planned the inspection to check whether the registered practice was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations.

The inspection was led by a Care Quality Commission (CQC) inspector who was supported by a specialist dental advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic appeared clean and well-maintained.
• The practice had infection control procedures which mostly reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• There was effective leadership and a culture of continuous improvement.
• The practice had staff recruitment procedures which mostly reflected current legislation.
• The practice had systems to manage risks for patients, staff, equipment and the premises. Improvements could be made in mitigating risks in relation to fire, sharps management and lone working.
• Staff felt involved, supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.

Background

High Oaks Dental Practice is in St Albans and provides NHS and private dental care and treatment for adults and children.

There is a small step into the practice with a removeable ramp for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 3 associate dentists and 1 locum dentist, 2 trainee dental nurses, 3 dental hygienists, a practice manager who is also a qualified dental nurse and 2 receptionists. A practice manager from a sister practice was also present on the day of the inspection. The practice has 2 treatment rooms.

During the inspection we spoke with 1 dentist, 1 trainee dental nurse, 1 dental hygienist, 1 receptionist and 2 practice managers. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday from 9am to 7pm

Tuesday, Wednesday, Thursday, Friday from 9am to 5pm

Saturday from 9am to 4pm.

There were areas where the provider could make improvements. They should:

• Take action to ensure ongoing fire safety management is effective. In particular, ensuring that regular in-house testing of fire detection equipment and fire evacuation drills are undertaken and that the smoke alarm is sited appropriately.

• Improve the practice's recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff. In particular, satisfactory evidence of conduct in previous employment (references) and evidence of effective immunity for vaccine preventable infectious diseases such as Hepatitis B.

• Improve the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 20.

• Take action to ensure audits of radiography are undertaken at regular intervals for all clinicians to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.